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Want to rescue rural America? Bust monopolies

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61–70 of 353 posts

Re: Want to rescue rural America? Bust monopolies

#61
They need to deregulate the entire medical industry, so anyone can start a medical practice. Right now, doctors control the supply of new medical licenses, and they're incentivized to restrict the supply so their own wages go up. The official line is that they can ensure high-quality medical treatments this way, but that's just something they tell themselves to feel good about it.

One of the consequences is that doctors are beholden to large corporations who have teams of lawyers to handle legal issues and malpractice lawsuits. Since there are limited slots, some of them even work in foreign countries until they get experience to land a job in the US, which is a waste of talent.

If anyone could start a medical practice, a new syringe company could sell to smaller practices that haven't yet been mired in enterprise contracts.

Right now, in order to even build a hospital you have to submit "evidence of need" to the government to get approval. Imagine if every startup had to convince a bureaucrat that they were needed: fewer people would be interested in starting one.

It's probably worth considering moving medical negotiations from insurance companies and employers to the consumer. I don't know that it's very common to call up multiple doctors and find the one with the lowest price, because you're paying your insurance company to do the negotiation for you. Taxing employer-provided health insurance as income might remove the incentive for them to provide it at all. Together with deregulating the entire medical industry, it would make it possible to buy cheap treatment without insurance, which might be enough to make insurance less important.

Re: Want to rescue rural America? Bust monopolies

#62
post #4

"I started a manufacturing company in Little Elm, about 35 miles north of Dallas, to produce the first-ever automatically retracting syringe to eliminate the risk of nurses contracting HIV through accidental needle sticks. The syringe received rave reviews from nurses, hospital executives and public health officials, a major grant from the National Institutes of Health and robust private investment. But when my partn…

I'm not sure what your point is. This isn't a free market because of monopolies or because of regulations?

To me, it seems like we have a completely free market here... and that is the problem. Companies are free to create and exploit monopolies. It's the final state of a completely free market.

Re: Want to rescue rural America? Bust monopolies

#63

Does anyone else think that nearly all huge companies exist due to monopolies or near-monopolies? MS has monopoly on desktops. Apple on cell phones and tablets. Facebook on social networking. Google on search. I think any market without at least 3-4 strong competitors will devolve into one dominant player who can milk more from the customer base.

Android has a higher market share than iOS. How does that make Apple a monopoly?

Re: Want to rescue rural America? Bust monopolies

#64
post #3

> In 1994, at the height of the AIDS crisis, in which I lost several friends and a beloved employee to the disease, I started a manufacturing company in Little Elm, about 35 miles north of Dallas, to produce the first-ever automatically retracting syringe to eliminate the risk of nurses contracting HIV through accidental needle sticks. The syringe received rave reviews from nurses, hospital executives and public heal…

I can speak for a different market in a different country (but I also lived in the US for a decade): IT freelancing in Germany. I get paid well, but there is something really strange going on: I can't get my contracts directly. I always have to go through a company whose sole business it is to be an intermediate between the (large) company that wants to hire a freelancer and the freelancer. Note that those freelancer…

Are there tax reasons as in the UK that make umbrella companies more common?

Re: Want to rescue rural America? Bust monopolies

#65
post #8
post #3

> In 1994, at the height of the AIDS crisis, in which I lost several friends and a beloved employee to the disease, I started a manufacturing company in Little Elm, about 35 miles north of Dallas, to produce the first-ever automatically retracting syringe to eliminate the risk of nurses contracting HIV through accidental needle sticks. The syringe received rave reviews from nurses, hospital executives and public heal…

Monopoly says you buy 100% of your products from us at 50% discount or 99% of your products from us at full price. Now someone is offering a better product but just that one product, so even if it was free your prices go up. See Intel discounts for avoiding AMD, or Microsoft discounts for avoiding Linux, or ... What do you do?

Your hypothetical scenario is suggesting that there are no alternative for 99% of the monopoly provider's products and only a better alternative from the 1%? No alternatives for the 99% even with a 50% markup (50 discounted vs 100 full price)? In that case, the buyer is much better off with a 50% discount on 99% of the products since no alternative exists, even at the 100 full price.

Re: Want to rescue rural America? Bust monopolies

#66
post #4

"I started a manufacturing company in Little Elm, about 35 miles north of Dallas, to produce the first-ever automatically retracting syringe to eliminate the risk of nurses contracting HIV through accidental needle sticks. The syringe received rave reviews from nurses, hospital executives and public health officials, a major grant from the National Institutes of Health and robust private investment. But when my partn…

Doesn't pass the smell test to me.

So a big company had 80% of the market? What about the other 20%?

Re: Want to rescue rural America? Bust monopolies

#67
post #4

"I started a manufacturing company in Little Elm, about 35 miles north of Dallas, to produce the first-ever automatically retracting syringe to eliminate the risk of nurses contracting HIV through accidental needle sticks. The syringe received rave reviews from nurses, hospital executives and public health officials, a major grant from the National Institutes of Health and robust private investment. But when my partn…

> A market in which buyers are not free to choose better products is not a free market.

Most businesses can choose better products (not sure about hospital industry). They can also choose to sign an agreement that makes a supplier relationship exclusive. For instance, a restaurant can sign an agreement to accept only Mastercard. Is this not a free market?

Re: Want to rescue rural America? Bust monopolies

#69

Highly relevant: Matt Stoller in The Atlantic: "How Democrats Killed Their Populist Soul In the 1970s, a new wave of post-Watergate liberals stopped fighting monopoly power. The result is an increasingly dangerous political system." https://www.theatlantic.com/politics/archive/2016/10/how-dem...

This really opened my eye: a long time ago, there was actually a meaningful difference between voting D and voting R. I can't really imagine voting in such a context, but it sounds nice...

[deleted]

Re: Want to rescue rural America? Bust monopolies

#70
post #65
post #8

Earlier quoted context omitted.

Monopoly says you buy 100% of your products from us at 50% discount or 99% of your products from us at full price. Now someone is offering a better product but just that one product, so even if it was free your prices go up. See Intel discounts for avoiding AMD, or Microsoft discounts for avoiding Linux, or ... What do you do?

Your hypothetical scenario is suggesting that there are no alternative for 99% of the monopoly provider's products and only a better alternative from the 1%? No alternatives for the 99% even with a 50% markup (50 discounted vs 100 full price)? In that case, the buyer is much better off with a 50% discount on 99% of the products since no alternative exists, even at the 100 full price.

That's the argument being made. The buyer is better off staying with the single supplier. The argument is that this is a breakdown in markets and should be regulated (for instance by breaking the supplier apart).
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